Euphoria in Real Life, and Minus Zendaya



Hope everyone has had a good week, mine has been relatively uneventful, but nevertheless I’m ready for the weekend and some Final Four Basketball. I’m thinking UConn is going to take home the ‘chip.


Now, this one is for two specific groups of people: those who love the show Euphoria and those addicted to opioids – which is more people than you think.


Why? Because Narcan was just federally approved for over the counter (OTC) sale by the FDA. Today, I’ll talk about why that matters to you.



Let’s set the scene


Opioids have become a big problem in the United States, as well as globally, with some people even calling it an “epidemic”.


The number of opioid related overdoses has increased by 500% over the last 12 years from ~20,000 deaths in 2010, to over 100,000 deaths in 2022. Opioids account for over 80% of all overdose deaths.

This is the one kind of chart you don’t want to see going up and to the right.




Obviously, it’s a very complex issue with lots of underlying factors but the way I see it there are really three things that I would consider bigger than the others:


  • That whole addiction thing: Opioids are super addictive compared to other drug categories. Less than 5% of addicts can successfully return to sobriety, meaning once you’re hooked you’ve pretty much got a death wish.
  • Access: It’s never been easier to access opioids than it is today.
  • Contamination: We’re seeing a lot more cases of what people would consider “recreational drugs” (cocaine, etc.) being contaminated or laced with fentanyl, which is leading to a lot of accidental overdose deaths.


So yea, it’s bad.


The good news is that in addition to what I’m writing about today, the government has begun holding pharma companies and prescribers accountable and making them dish out billions and billions of dollars in settlements.




Help us Obi-one Kenobi Narcan, you’re our only hope


There’s really only one way to survive an overdose, and that’s Narcan (naloxone hydrochloride). Narcan is the only medication that can reverse an overdose in real time by binding to the same receptors that opioids do, thus kicking them out.


Narcan is the stickler at a sporting even that comes up and says “hey, you’re in my seat” … which makes you the opioid in that example lol.


And there aren’t too many severe side effects. Just the usual headache, irritation, or opioid withdrawals.




How does it work now?


This ruling isn’t too groundbreaking because every state has allowed pharmacies to sell Narcan OTC. But even with the states doing this, not every pharmacy carries it, it’s expensive, and distribution is difficult. Right now, distribution relies a lot on community organizations, so I’d imagine putting industry logistics behind this will only help improve access.


Not only that, but if you choose to use insurance, the insurance company will flag this and actually increase your rates because you are now considered a high-risk client.




What’s it going to look like moving forward?


The federal legislation will actually change a lot. For one, it will enable federal distribution which will reduce the price and increase the availability.


It will be carried everywhere, not just a CVS or Walgreens. You can expect to see it in supermarkets, convenient stores, and online. I would expect local businesses to keep some handy too, with restaurants viewing it similarly to having an AED or fire extinguisher.


All of that said, it will be interesting to monitor because Narcan doesn’t fix the root of the problem, it just treats a symptom. How to attack the opioid problem has been heavily debated, from allowing safe spaces to shoot up to just banning them outright, but it’s been slow moving and difficult to get to the bottom of.


While Narcan doesn’t fix the problem, it will definitely help in reducing deaths, specifically those attributed to “accidental overdoses”.



Final thoughts


Due in large part to the reasons I outlined in my previous blog post here, there is lots of competition among manufacturers.


The most recent approval only covers Emergent Biosolutions, so they have a head start on the rest of suppliers, but I would expect nearly every other manufacturer to file for approval within the next few weeks as everyone tries to gain market share.


For now, it looks like Emergent Biosolutions will reap the benefits until then. Here’s a graph we like to see go up and to the right.



Let’s have ourselves a weekend.

from, matt

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